This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. That a culturally sensitive tailored lifestyle intevention will improve outcomes in African Americans with metabolic syndrome compared with usual care in a primary care ssetting. Specific Aims: To promote physician awareness and patient lifestyle interventions to enhance treatment and outcomes of CV risk factors associated with MetS in hypertensive African Americans. To develop and evaluate the effects of a culturally- sensitive self- management lifestyle intervention (LSI) on health behaviors, clinical outcomes and psychosocial factors in hypertensive AA with CV risk factors associated with the MetS. Primary outcome: To determine if participants who receive the LSI intervention demonstrate improved health behaviors over participants randomized to usual care (UC) as exhibited by: increased exercise tolerance test (treadmill), increased PA levels (Mets-h/week from modified Baeke Questionnaire);improved dietary patterns (Block Questionnaire), and improved medication compliance (Hill-Bone Questionnaire). 2b2. Secondary outcomes: To determine if participants who receive the LSI demonstrate improved clinical outcomes over those randomized to UC as exhibited by: lower systolic and diastolic BP, lower weight, improved serum total cholesterol, high density lipoproteins, and triglyceride levels, and improved metabolic and inflammatory profile (fasting glucose, two hour glucose, fasting insulin, HOMA, CRP). 2b3. Tertiary outcomes: To determine if participants who receive the LSI experience improved health- related quality of life (HRQOL) and psychosocial factors over those receiving UC as exhibited by improved overall physical and mental functioning (SF-36), lower perceived stress, lower depressive symptoms, increased social support, increased diet and PA self efficacy, and increased stage of change for PA. Experimental Protocol: Three separate focus groups with six-eight CPN patients diagnosed with the MetS will be conducted to determine acceptance of the content of the intervention and correspondence with the needs of the population, preferred styles of materials, perceived barriers/benefits of participating in the intervention, and perceived barriers/benefits for improved health behaviors. A two-arm, parallel-group, multi-center design will be used to randomize subjects within the CPN to usual care (UC) or the LSI intervention. Participants randomized to UC will receive usual care from their provider, and will be given a MetS resource folder consisting of information and healthy lifestyle recommendations. Participants randomized to the LSI group will receive UC plus six group sessions designed to improve PA, diet and medication compliance, followed by 10 phone counseling sessions by a CHW. Baseline, three, six and twelve month evaluations will be completed for both groups.